title: Successful management of perforated duodenal diverticulitis with intra-abdominal drainage and feeding jejunostomy: a case report and literature review.
abstract: We report the clinical experience of one patient with perforated duodenal diverticulitis who was successfully treated by intra-abdominal drainage and feeding jejunostomy. A 53-year-old male patient visited our hospital due to acute onset of abdominal pain and distension. Physical examination revealed tenderness over the epigastric area and right-lower quadrant of the abdomen without obvious rebound tenderness or muscle guarding. Duodenal diverticulitis with a retroperitoneal abscess was identified by abdominal computed tomography scan. Surgical intervention was performed after the failure of conservative treatment. The operative findings were compatible with perforated duodenal diverticulitis, and intra-abdominal drainage of retroperitoneal abscess with simultaneous feeding jejunostomy was undertaken. The patient was doing well at the 4-month postoperative follow-up visit. We suggest the use of a conservative operative method, as opposed to conventional diverticulectomy and duodenorrhaphy, as an alternative approach for the management of this disorder, especially when conservative treatment has failed.
authors.affiliation: Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Chin-Fan
authors.initials: CF
authors.lastname: Chen
authors.forename: Deng-Chyang
authors.initials: DC
authors.lastname: Wu
authors.forename: Chao-Wen
authors.initials: CW
authors.lastname: Chen
authors.forename: Jan-Sing
authors.initials: JS
authors.lastname: Hsieh
authors.forename: Chiao-Yun
authors.initials: CY
authors.lastname: Chen
authors.forename: Jaw-Yuan
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000005:Abdomen / Q000601:surgery*; D004238:Diverticulitis / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D004322:Drainage; D004386:Duodenum / Q000000981:diagnostic imaging; D004750:Enteral Nutrition; D005500:Follow-Up Studies; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015898:Tomography Scanners, X-Ray Computed